Single injection of HDL could stop heart cells dying

Media release

Australian researchers demonstrate how a single injection of HDL could stop heart cells dying and improve heart function after a heart attack

A single injection of high-density lipoprotein (HDL) delivered immediately after a heart attack has been shown to increase cardiac glucose uptake, stop heart cells and tissue dying, and improve heart function to prevent progression to heart failure, according to a new study by Australian researchers.

Scientists from the Baker Heart and Diabetes Institute have shown in a preclinical study that the delivery of HDL within hours after a heart attack can act quickly on glucose metabolism, reducing the impact on heart cells and promoting functional recovery of the heart.

The findings, published today in Science Translational Medicine, provide a potentially exciting and feasible approach that can be delivered during lifesaving cardiac care to improve outcomes for the 54,000 Australians who suffer a heart attack every year.

Professor Kingwell says this latest finding targets cardiac glucose metabolism at this critical period. The study also found HDL was equally effective in the presence of diabetes, which is important because people with diabetes have a higher risk of heart disease, including heart attack.

This work builds on a pivotal discovery by Baker Institute scientists in 2009 showing that HDL modulated glucose metabolism in skeletal muscle and reduced plasma glucose in individuals with type 2 diabetes.

Professor Kingwell emphasises that this mechanism targeting glucose metabolism is very different to those targeted by a number of HDL therapies to regress or stabilise fatty plaque build-up in arteries.

While there has been significant development of drugs over the past few decades to reduce cardiovascular disease such as the introduction of statins to clinical practice, Professor Kingwell says there are few therapeutic options to reduce the impact of heart attack.

“Importantly, this study has direct relevance for the management of heart attack in today’s health care setting, with the proposal that a single dose of HDL, sourced from a reconstituted blood product (apolipoprotein A-I), can be delivered intravenously while blood vessels are being opened in the cardiac catheter laboratory as part of lifesaving cardiac care,” Professor Kingwell says.

At least two pharmaceutical companies already have infusible formulations of HDL in clinical trials for other indications, including a product by CSL Limited which has recently shown encouraging safety data in trials of patients with acute coronary syndrome.

Around 54,000 Australians suffer a heart attack every year — that’s one heart attack every 10 minutes. In 2015, heart attack claimed the life of more than 8400 Australians.